Avery, Samantha R

Avery, Samantha R is an individual health care provider with primary practice located at 1615 Pasadena Ave S Ste 300 , South Pasadena FL 33707-4567. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Cardiovascular Disease. Allopathic & Osteopathic Physicians / Cardiovascular Disease is her primary health care specialty. Avery, Samantha R can be contacted via phone (277) 490-3030.

Contact Information

Primary practice address
1615 Pasadena Ave S Ste 300 South Pasadena FL 33707-4567
Phone: (277) 490-3030
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X OS 11371 Florida

Profile Details

NPI number 1215178090
LBN Legal business name Avery, Samantha R
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 9th, 2009
Last updated Jan 31st, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1215178090 NPPES
Florida Other HT787Z MEDICARE ID-TYPE UNSPECIFIED

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